MEDICARE: MISS MONIQUE ANTOINETTE WILLIAMS LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker
2	104100000X	Social Worker	011757	CT

General Provider Information

NPI Number	:	1710232277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS MONIQUE ANTOINETTE WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	2 SUMMER HILL RD.
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-5645
Country	:	US
Telephone Number	:	617-817-2538
Fax Number	:

Provider Business Practice Location Address
First Line	:	410 STATE STREET
Second Line	:
City	:	NORTH HAVEN
State	:	CT
Zip	:	06473-3147
Country	:	US
Telephone Number	:	203-936-9213
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	07/18/2023

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